- •Foreword
- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •References
- •References
- •Introduction
- •Eyelid Anatomy
- •Eyelid Skin
- •The Orbicularis Muscle
- •The Orbital Septum
- •The Preaponeurotic Fat Pockets
- •The Major Eyelid Retractors
- •The Sympathetic Eyelid Retractors
- •The Tarsal Plates
- •The Canthal Tendons
- •The Conjunctiva
- •Nerves to the Eyelids
- •Vascular Supply to the Eyelids
- •Upper Eyelid Physiology
- •References
- •Introduction
- •Ocular Surface Disease
- •Medications
- •Prior Ocular and Periocular Surgery
- •Contact Lens Use
- •Miscellaneous Conditions
- •Congenital Ptosis
- •Conclusion
- •References
- •Recognise the Ptosis!
- •Unsafe Ptosis
- •Safe Ptosis
- •Distinguishing Safe Ptosis from Unsafe Ptosis
- •Lifting the Ptotic Lid
- •Contralateral Lid Retraction
- •Proptosis and Enophthalmos
- •Frontalis Overaction
- •The Dry Eye Patient
- •Definitive Examination of the Ptosis
- •Special Diagnostic Tests for Ptosis
- •References
- •Introduction
- •History
- •Physical Exam
- •Determination of Procedure
- •Blood Thinners
- •Patient Expectations
- •When Not to Operate
- •References
- •References
- •Pathogenesis
- •Myogenic Causes
- •Aponeurotic Causes
- •Mechanical Causes
- •Neurogenic Causes
- •Pseudoptosis
- •Examination
- •Preoperative Considerations
- •Surgical Repair
- •Müllerectomy
- •Levator Resection
- •Frontalis Suspension
- •Conclusions
- •References
- •Introduction
- •Background
- •Etiology
- •Clinical Findings
- •Ophthalmic Exam
- •Treatment
- •Conclusions
- •References
- •Introduction
- •Congenital Myogenic Ptosis
- •Acquired Myogenic Ptosis
- •Evaluation of the Patient
- •Treatment
- •References
- •Overview
- •Diagnosis: Clinical
- •Diagnosis: Testing
- •Medical Therapy
- •Surgical Therapy
- •References
- •Introduction
- •Third Nerve (Oculomotor) Palsy
- •Diagnosis
- •Localization of a Third Nerve Palsy
- •Common Etiologies for Third Nerve Palsy
- •Horner Syndrome
- •Diagnosis
- •Pharmacologic Evaluation
- •Localization of Horner Syndrome
- •Radiographic Evaluation
- •Horner Syndrome in Children
- •Treatment
- •References
- •Introduction
- •Iatrogenic Causes of Ptosis
- •Ptosis Postintraocular Surgery
- •Ptosis Posteyelid and Adnexal Procedures
- •Contact Lens Wear
- •Ptosis Following Systemic Interventions
- •Birth Trauma
- •Blunt Trauma
- •Lacerating Trauma
- •Traumatic Ptosis Secondary to Restrictive Scarring
- •Traumatic Ptosis Following Facial Fractures
- •Neurogenic Ptosis Secondary to Trauma
- •Traumatic Superior Orbital Fissure Syndrome
- •Blepharoptosis Secondary to Traumatic Third Nerve Palsy
- •Isolated Neurogenic Ptosis
- •Traumatic “Ptosis” Secondary to Facial Synkinesis
- •References
- •Etiology
- •Evaluation
- •Solutions
- •Conclusion
- •References
- •Introduction
- •Pathophysiology
- •Clinical Evaluation
- •Surgical Management
- •Minimal Lash Ptosis
- •Moderate to Severe Lash Ptosis
- •Conclusion
- •References
- •Introduction
- •Mechanical Measures
- •Lid Crutches
- •Eyelid Taping
- •Glues
- •Apraclonidine
- •Medical Measures: Botulinum Toxin
- •References
- •Introduction
- •Procedure
- •Conclusion
- •Suggested Reading
- •Introduction
- •Principle of the Procedure
- •Methodology of the Procedure
- •References
- •Technique [5]
- •References
- •Introduction
- •Surgical Technique
- •Preservation of the Conjunctiva
- •Discussion
- •References
- •History
- •Mechanism of Action
- •Indications
- •Procedure
- •Description of the Procedure
- •Complications
- •Discussion
- •References
- •Indications
- •Techniques
- •Lamellar Technique
- •En Bloc Technique
- •Challenges and Solutions
- •Pearls
- •References
- •Indications
- •Autologous Tissue for Frontalis Suspension
- •Autogenous Fascia Lata
- •Harvesting Fascia Lata
- •Temporalis Fascia
- •Harvesting Deep Temporalis Fascia
- •Palmaris Longus Tendon
- •Harvesting Palmaris Longus Tendon
- •Frontalis Muscle Flap Advancement
- •Allografts for Frontalis Suspension
- •Preserved Fascia Lata
- •Other Processed Tissues
- •Synthetic Materials for Frontalis Suspension
- •Techniques for Frontalis Suspension
- •Double Triangle or Rhomboid Frontalis Sling
- •Single Pentagonal Frontalis Sling
- •References
- •The Transition to Office-Based Surgery
- •Reasons to Transition
- •Surgical Space and Equipment
- •State Regulations
- •Procedure Selection
- •Patient Selection
- •Evaluating Patients at Risk for Anxiety
- •Nonmedical Prevention of Anxiety
- •Medical Prevention of Anxiety
- •Postoperative Nausea and Vomiting
- •Anesthesia for Surgery
- •Topical Anesthetics
- •Injectable Anesthetics
- •Postoperative Pain Control
- •Conclusion
- •References
- •References
- •References
- •Etiology and Evaluation
- •Treatment
- •Surgical Technique
- •Aporneurotic Ptosis Repair
- •Frontalis Sling
- •Complications
- •Summary
- •Tarsal Switch
- •Severe Horizontal Eyelid Laxity
- •Inadequate Tarsus
- •Neurofibromatosis
- •References
- •Involutional/Aponeurotic ptosis
- •Levator Advancement/Plication
- •Congenital Myogenic Ptosis
- •Frontalis Suspension
- •Levator Resection
- •Maximal Levator Resection
- •Whitnall’s Sling
- •Summary
- •References
- •Introduction
- •Preoperative Factors
- •Intraoperative Factors
- •Postoperative Factors
- •Surgical Approach to Ptosis Reoperation
- •Summary
- •References
- •Entropion
- •Symblepharon
- •Ectropion
- •Contour Deformity
- •Lagophthalmos
- •Eyelid Fold and Crease
- •Conjunctival Prolapse
- •Hemorrhage/Hematoma
- •Infection
- •Conclusion
- •References
- •Twelve Steps to a Successful Surgical Encounter
- •Index
Acknowledgments
I would like to acknowledge, with gratitude, my parents, family, friends, teachers, and patients.
—Adam J. Cohen
To my wife, Rebecca, whose editorial support was immeasurably helpful, and my three wonderful children, Elena, Sara, and Jonathan.
—David A. Weinberg
xi
Contents
Part I Introduction |
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1 |
Introduction............................................................................... |
3 |
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Adam J. Cohen and David A. Weinberg |
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2 The History of Ptosis Surgery................................................... |
5 |
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Mithra O. Gonzalez and Vikram D. Durairaj |
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3 Eyelid Anatomy and Physiology with Reference |
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to Blepharoptosis....................................................................... |
13 |
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Jonathan J. Dutton and Bartley R. Frueh |
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Part II |
Approach to the Ptosis Patient |
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4 Risk Factor Assessment Prior to Ptosis Surgery.................... |
29 |
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David I. Silbert |
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5 Ptosis: Nailing the Diagnosis and Considering |
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the Differential Diagnosis.......................................................... |
37 |
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Geoff Wilcsek and Ian C. Francis |
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6 Preoperative Decision Making in Ptosis Surgery................... |
49 |
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Chris Thiagarajah and Robert Kersten |
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Part III |
Ptosis Subtypes |
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7 |
Pseudoptosis............................................................................... |
61 |
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Adam J. Cohen and David A. Weinberg |
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8 |
Congenital Ptosis....................................................................... |
67 |
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Edward J. Wladis and Dale R. Meyer |
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9 |
Involutional Ptosis..................................................................... |
73 |
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Jose Luis Tovilla |
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xiii
xiv |
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Contents |
10 |
Myogenic Ptosis.......................................................................... |
79 |
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Natan D. Kahn and David A. Weinberg |
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11 |
Myasthenia Gravis..................................................................... |
107 |
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Ippolit C. A. Matjucha |
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12 |
Neurogenic Blepharoptosis....................................................... |
115 |
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Jonathan W. Kim |
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13 |
Traumatic Blepharoptosis......................................................... |
129 |
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Nariman S. Boyle and Eli L. Chang |
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14 |
Anophthalmic Ptosis.................................................................. |
141 |
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Ann P. Murchison and Jurij R. Bilyk |
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15 |
Lash Ptosis.................................................................................. |
147 |
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Renzo A. Zaldívar, Michael S. Lee, |
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and Andrew R. Harrison |
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Part IV Treatment |
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16 |
The Nonsurgical Treatment of Ptosis....................................... |
155 |
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Ippolit C. A. Matjucha |
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17 |
External Levator Resection...................................................... |
163 |
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Morris E. Hartstein, Natan D. Kahn, and David A. Weinberg |
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18 |
Minimal Dissection, Small Incision Ptosis Correction........... |
175 |
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Bartley R. Frueh |
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19 |
Müller’s Muscle-Conjunctival Resection |
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(Posterior Approach)................................................................. |
179 |
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Adam J. Cohen and David A. Weinberg |
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20 |
Open-Sky (Anterior Approach) Müller’s Muscle Resection |
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for the Correction of Blepharoptosis....................................... |
189 |
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Heather Baldwin |
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21 |
The Fasanella–Servat Procedure for Ptosis............................. |
197 |
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Kim Jebodhsingh, James Oestreicher, and John T. Harvey |
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22 |
Full-Thickness Eyelid Resection for Blepharoptosis |
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Correction................................................................................... |
207 |
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Shu-Hong Chang and Norm Shorr |
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23 |
Frontalis Suspension for the Correction |
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of Blepharoptosis....................................................................... |
217 |
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Eve E. Moscato and Stuart R. Seiff |
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Contents |
xv |
Part V Other Considerations |
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24 In-Office Surgery, Anesthesia, and Analgesia......................... |
231 |
C. Robert Bernardino |
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25 Ethnic and Gender Considerations in Ptosis Surgery............ |
243 |
Jed Poll and Michael T. Yen |
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26 Aesthetic Considerations for the Ptosis Surgeon.................... |
249 |
Adam J. Cohen and David A. Weinberg |
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27 Challenging Ptosis Scenarios.................................................... |
253 |
John B. Holds, Adam G. Buchanan, Morris Hartstein, |
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David A. Weinberg, and Adam J. Cohen |
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28 Ptosis Surgery: Comparing Different Surgical |
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Techniques.................................................................................. |
263 |
Alon Skaat and Guy Jonathan Ben Simon |
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29 Ptosis Surgery Failure and Reoperation.................................. |
269 |
Jill Melicher and Jefferey A. Nerad |
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30 Complications of Ptosis Repair: Prevention |
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and Management....................................................................... |
275 |
Milad Hakimbashi, Don O. Kikkawa, and Bobby S. Korn |
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31 Commentary: Perspective of a Risk Manager: |
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12 Steps of a Successful Surgical Encounter........................... |
289 |
John Shore |
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32 Conclusion.................................................................................. |
301 |
Adam J. Cohen and David A. Weinberg |
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Index................................................................................................... |
303 |
